C-Section by Choice

Depending upon where you have your baby and who your providers are, you will likely have choices in how you give birth. One choice that you may be considering is whether you should opt for a Cesarean or surgical birth, also known as a C-section. Read on to learn more about why the choice may or may not be for you.

A C-section is major abdominal surgery that takes place in an operating room. Doctors perform C-sections, assisted by nurses and medical assistants. During a Cesarean birth, an incision is made, usually low on the belly, and baby is born through that incision. After removal of the placenta, the surgeon closes the incision. Except in emergency situations, you can receive epidural anesthesia in advance of a surgical birth that will numb you from the waist down. In this way, you can be awake to meet your baby. In many cases, baby can be placed on your or your partner’s chest for skin-to-skin right after birth.

In the U.S., about a third of babies are born via planned or emergency Cesarean section. There are any number of reasons why you might opt for a C-section during your birth. They can include:

  • A situation your health or baby’s health are in jeopardy and the best way to ensure everyone’s safety is for baby to be born surgically
  • Cord prolapse, an emergency in which the umbilical cord slips out of the birth canal ahead of baby, which means that baby could push on it and cut off their own oxygen supply
  • Very long labor
  • Baby is in a position that makes it hard or impossible for them to descend into your pelvis

Before experiencing any of these scenarios, you might have planned or hoped for a vaginal birth, but made a different choice in the moment. If you are struggling emotionally with having made that choice, this The Pulse blog post offers reassurance and may normalize your experience. In short, a birth is a birth and you are a great parent, regardless of your baby’s mode of entry into the world.

You may still be pregnant and wondering if you should plan to have a surgical birth. Because C-sections come with potential complications, including increased risk of infection and longer recovery time than most vaginal births, talk to your care provider about whether or not surgical birth is the best choice for you. Some of the reasons you might schedule your Cesarean ahead of time are:

  • Placental issues, such as placenta previa, where the placenta covers the cervix
  • Breech positioning of the baby, where their feet or bottom are down in the pelvis, rather than their head, which is traditionally born first. Some care providers are comfortable delivering breech babies vaginally, but many are not.
  • Having had a previous C-section, especially if vaginal birth after Cesarean or VBAC is not an option for you
  • If your baby has birth defects that would lead them to experience greater-than-normal stress during labor and vaginal delivery
  • Multiples are often delivered by Cesarean, though, depending upon the expertise of your providers and babies’ positions in the womb, it is possible to birth them vaginally.
  • Previous traumatic labor or vaginal birth may mean that a Cesarean is the right choice for you in subsequent pregnancies.

If you are planning a Cesarean birth, you might want to consider gentle or family-centered Cesarean. This type of birth is gaining popularity, especially in cases where you would have preferred a vaginal birth instead. Though exactly how this experience goes varies by hospital and depends upon your care provider, your a family-centered Cesarean might include the following:

  • The ability to have more than one support person with you in the operating room. Perhaps your partner and doula can be there.
  • Your favorite music playing during birth.
  • Introductions to your surgical team and narration or explanations of everything they are doing as they do it.
  • Delayed cord clamping, in which baby’s cord is not clamped and cut right away to allow more blood to flow from the placenta into baby’s body
  • Lowered or clear drape so that you can witness baby’s birth
  • Immediate skin-to-skin
  • Delaying newborn exam until you and baby are back in the hospital room
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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